Appendix B

Key Terminology and Definitions Shared with Workshop Participants

• Circular Economy/Circularity: A system where materials never become waste, the life of the product is extended, and nature is regenerated. In a circular economy, products and materials are kept in circulation through processes such as maintenance, reuse, refurbishment, remanufacture, recycling, and composting. The circular economy tackles climate change and other global challenges, such as biodiversity loss, waste, and pollution, by decoupling economic activity from the consumption of finite resources (Ellen MacArthur Foundation, n.d.; EPA, 2023; European Parliament, 2023).
• Health Care Setting or Facility: Places where a broad array of health care services occurs, including acute care hospitals, urgent care centers, rehabilitation centers, nursing homes and other long-term-care facilities, specialized outpatient services, and outpatient surgery centers (Christensen and Fagan, 2018).
• Health Care Textiles (HCTs): Fabric-based products that touch patients and employees directly or indirectly on a daily basis in a health care setting (CDC, 2003; McLay, 2016).
  • Disposable HCTs: Generally, serve only as single-use products in health care facilities and many other institutional protective clothing applications for a given length of time. In some cases, these HCTs can be disposed of as commercial or regulated medical waste. However, in cases of contamination with infectious materials, these HCTs will be discarded as infectious waste (CDC, 2003; DOT, 2022).

• • Reusable HCTs: Designed to be repeatedly used in health care facilities. After each usage, the textiles should be laundered following the CDC’s guidelines. When laundered, the used textiles are not only cleaned but also disinfected with bleaching agents such as diluted sodium hypochlorite solution or concentrated hydrogen peroxide solution (CDC, 2003). NOTE: While the workshop included discussion of reusable respirators, these are not reusable HCTs.
• Health Care Worker: Any individuals working within a health care setting who would need to use health care PPE or come into direct contact with health care PPE.
• Life-Cycle Analysis (LCA): A systematic analysis of environmental impact over the course of the entire life cycle of a product, material, process, or other measurable activity. LCA models the environmental implications of the many interacting systems that make up industrial production (RIT, 2020).
• Lifespan: Time interval from when a product is sold to when it is discarded (Murakami et al., 2010).
• Medical Gown: A type of personal protective equipment used in health care settings that can cover the entire middle of the body (back and front) from top of shoulders to knees and the arms to the wrist. The requirements for the design and construction of different medical gowns are based on the anticipated location and degree of liquid contact, given the expected conditions of use. (FDA, 2024; NIOSH, 2020).
  • Isolation Gown: A type of medical gown designed to isolate as much of the wearer as possible from exposure/contact with blood, body fluids, and other potentially infectious materials. The entire isolation gown, including the seams, but excluding the cuffs, hems, and bindings, must achieve claimed barrier performance (NIOSH, 2020).
  • Surgical Gown: A type of medical gown designed to primarily isolate the wearer’s front and arms from exposure/contact with blood, body fluids, and other potentially infectious materials (NIOSH, 2020).
• Personal Protective Equipment (PPE): Equipment worn to minimize exposure to a variety of hazards. Examples include gowns, gloves, foot protection, face and eye protection, protective hearing devices (earplugs, muffs), hard hats, respirators, and full-body suits (OSHA, 2023).
  • Health Care PPE: PPE designed to protect the wearer from injury or the spread of infection or illness in health care set

• • tings. Examples include gowns, gloves, face and eye protection, respirators, and full-body suits (FDA, 2022).
  • Disposable PPE: PPE designed to be used only one time and by one person prior to disposal (Sun, 2011).
  • Reusable PPE: PPE designed to be reused and able to withstand numerous cleanings, decontaminations, launderings, and sterilizations. For the purposes of this workshop, the planning committee considered the following items to be included as reusable PPE for health care: isolation gowns, surgical gowns, reusable elastomeric half-mask respirators (EHMRs) (Sun, 2011). NOTE: While the workshop included discussion of reusable EHMRS and other reusable respirators, these are not reusable HCTs.
• (Re)Processing: A detailed, multistep process to clean and then disinfect or sterilize reusable medical devices including reusable PPE and reusable HCTs (FDA, 2023).
• Standards Organizations: Organizations whose primary function is developing, coordinating, promulgating, revising, amending, reissuing, interpreting, or otherwise contributing to the usefulness of technical standards (Ping, 2011). Common standards organizations involved in PPE and HCT standards include the Association for the Advancement of Medical Instrumentation, American Association of Textile Chemists and Colorists, American National Standards Institute, and ASTM International.
• Value Analysis: Evidenced-based, systematic approach to review health care products, equipment, technology, and services. Using recognized practices, organizational resources collaborate to evaluate clinical efficacy, appropriate use, and safety for the greatest financial value (Nadeau, 2024).
• Value Chain: An analytical way to disaggregate a company into its strategically relevant activities in order to focus on the sources of competitive advantage, that is, the specific activities that result in higher prices or lower costs (Harvard Business School, n.d.).

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